Publications by authors named "Thomas Kueffer"
Background: Early recurrences of atrial tachyarrythmias (ERAT) after pulmonary vein isolation (PVI) are common. While many correlate to late recurrences (LR), some do not. The impact of ERAT timing is difficult to assess with non-invasive holter monitoring due to undersampling.
View Article and Find Full Text PDFPulsed Field Ablation as First-Line Therapy for Atrial Fibrillation: A Substudy of the EU-PORIA Registry.
Circ Arrhythm Electrophysiol
December 2024
Background: Recent studies have demonstrated the benefit of early ablation in preventing the progression of atrial fibrillation (AF). Clinical practice has reflected this shift in AF management and no longer requires patients to fail antiarrhythmic drugs (AADs) before receiving ablation. However, there is limited evidence on outcomes with pulsed field ablation (PFA) as a first-line therapy.
View Article and Find Full Text PDFCharacteristics of electrograms depend on the electrode design and distance to the electric source. Our aim was to assess the impact of electrode design and distance from the myocardial electric source on the unipolar and bipolar electrograms to deduce a far-field cut-off. We retrospectively analyzed left atrial electroanatomical maps of 25 patients acquired using an ablation catheter with a 4.
View Article and Find Full Text PDFArticle Synopsis
- Advanced bipolar radiofrequency catheter ablation (Bi-RFA) is being studied as a new treatment for patients with ventricular tachycardia (VT) and premature ventricular contractions (PVC) that do not respond to standard unipolar radiofrequency ablation (Uni-RFA).
- A multicenter registry conducted in Europe showed that out of 91 patients treated with Bi-RFA, 74% achieved elimination of clinical VT/PVC, and 78% experienced a significant reduction in PVC burden during follow-up.
- The procedure was found to be generally safe and feasible, though there were some major complications reported, indicating that Bi-RFA could be a valid option for managing refractory VT/PVC
Background: The role of catheter ablation in elderly patients with atrial fibrillation (AF) is unclear. Pulsed field ablation (PFA) demonstrates a favorable clinical profile, however, data on elderly patients are lacking.
Aims: We aimed to assess the safety and efficacy of PFA in the elderly, using data from the EU-PORIA registry.
Article Synopsis
- Single-shot devices, like the Arctic Front cryoballoon, are becoming popular for pulmonary vein isolation in atrial fibrillation, with a new option, the FARAPULSE pulsed field ablation device, aiming for better safety and effectiveness.
- The SINGLE SHOT CHAMPION trial involves 210 patients with paroxysmal atrial fibrillation randomly assigned to either the FARAPULSE or the cryoballoon treatment, with thorough monitoring for outcomes.
- The study's primary focus is on the first recurrence of atrial tachyarrhythmias within a year after the procedure, alongside safety measures and quality of life assessments.
Article Synopsis
- - The study compared the effects of dexmedetomidine and propofol on heart function in patients undergoing atrial fibrillation ablation, focusing on how each sedative impacts sinus node function and atrioventricular (AV) conduction.
- - A total of 160 patients were enrolled, with findings indicating that patients given dexmedetomidine experienced slower sinus rates and prolonged AV conduction times compared to those given propofol.
- - Despite these differences, both sedatives did not significantly affect certain aspects of heart conduction, such as infrahissian AV conduction and ventricular repolarization, and arrhythmia occurrence was similar across both groups.
Aims: Atrial fibrillation (AF) ablation and left atrial appendage occlusion (LAAO) are increasingly performed as individual procedures. Pulsed field ablation (PFA) has significantly reduced procedure duration and may be advantageous for the combined approach.
Methods And Results: We have launched a programme for simultaneous AF ablation using PFA and LAAO for patients qualifying for both treatments and excluding those with a complex anatomy.
Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).
Objective: To assess the outcomes of pulsed-field ablation (PFA) in HF.
Background: Atrial fibrillation (AF) and heart failure (HF) coexist, increasing morbidity and mortality. Studies have demonstrated improved outcomes following AF ablation in HF patients with reduced ejection fraction (EF).
Objective: This study sought to assess the outcomes of pulsed field ablation (PFA) in HF.
Background: Pulsed-field ablation (PFA) is a novel nonthermal ablation technology. Its potential value for repeat procedures after unsuccessful thermal ablation for atrial fibrillation has not been assessed.
Objective: The purpose of this study was to summarize our initial experience with patients undergoing repeat procedures using PFA.
Article Synopsis
- Pulmonary vein isolation is an effective treatment for atrial fibrillation, with cryoballoon ablation being superior to medication; the study compares the new PolarX cryoballoon with the existing Arctic Front cryoballoon.
- Patients with symptomatic paroxysmal atrial fibrillation were randomly assigned to receive either cryoballoon treatment and monitored for recurrence of atrial tachyarrhythmias and procedural safety within one year.
- Results showed that the PolarX cryoballoon had a similar effectiveness compared to Arctic Front but caused significantly more cases of phrenic nerve palsies (5% vs. 0%).
Background: Recurrence of paroxysmal atrial fibrillation (AF) following pulmonary vein isolation (PVI) is presumably caused by pulmonary vein (PV) reconnections. However, there is little data available on the durability of PVI and incidence of arrhythmia recurrence in patients with persistent AF.
Objectives: The purpose of this study was to evaluate the lesion durability by means of an a priori planned remapping procedure in patients with persistent AF undergoing CLOSE-guided PVI.
Background: Pulsed-field ablation (PFA) has shown promising data in terms of safety and procedural efficiency for pulmonary vein isolation (PVI), with similar long-term outcomes compared to radiofrequency ablation (RFA) and cryoballoon ablation (CBA) in patients with paroxysmal atrial fibrillation (AF).
Objective: The purpose of this study was to compare the procedural and long-term outcomes in patients with persistent AF undergoing PVI using PFA, CBA, or RFA.
Methods: Consecutive patients with persistent AF undergoing first PVI with PFA, CBA, or RFA were included.
Article Synopsis
- Pulmonary vein isolation (PVI) alone is often inadequate for treating persistent atrial fibrillation, and adding left atrial posterior wall (LAPW) ablation has had mixed results due to concerns about safety and effectiveness.
- This study compares the safety and effectiveness of PVI combined with LAPW ablation versus PVI alone using pulsed-field ablation (PFA) in patients with persistent atrial fibrillation.
- Results show no significant difference in freedom from arrhythmias or major adverse events between the two groups, indicating that adding LAPW ablation may not improve outcomes in this patient population.
Background: Pulsed-field ablation (PFA) is a novel nonthermal ablation technology with high procedural safety and efficiency for pulmonary vein isolation (PVI). Premarket data showed high PVI durability during mandatory remapping studies. Data on lesion durability in real-world patients with clinically indicated redo procedures are scarce.
View Article and Find Full Text PDFAims: The left atrial posterior wall is a potential ablation target in patients with recurrent atrial fibrillation despite durable pulmonary vein isolation or in patients with roof-dependent atrial tachycardia (AT). Pulsed-field ablation (PFA) offers efficient and safe posterior wall ablation (PWA), but available data are scarce.
Methods And Results: Consecutive patients undergoing PWA using PFA were included.
Importance: Previous studies evaluating the association of patient sex with clinical outcomes using conventional thermal ablative modalities for atrial fibrillation (AF) such as radiofrequency or cryoablation are controversial due to mixed results. Pulsed field ablation (PFA) is a novel AF ablation energy modality that has demonstrated preferential myocardial tissue ablation with a unique safety profile.
Objective: To compare sex differences in patients undergoing PFA for AF in the Multinational Survey on the Methods, Efficacy, and Safety on the Postapproval Clinical Use of Pulsed Field Ablation (MANIFEST-PF) registry.
Background: Pulsed-field ablation (PFA) has shown favourable data in terms of safety and procedural efficiency for pulmonary vein isolation (PVI). We sought to compare procedural and 1-year follow-up data of patients with paroxysmal atrial fibrillation (AF) undergoing PVI using PFA, cryoballoon ablation (CBA) and radiofrequency ablation (RFA).
Methods: Consecutive patients with paroxysmal AF undergoing a first PVI with PFA at our institution were included.
Article Synopsis
- The study examines the effectiveness of two cryoballoon devices (PolarX and Arctic Front) for treating atrial fibrillation through a multicenter, randomized clinical trial involving 200 patients.
- The primary goal is to determine the time until the first recurrence of atrial tachyarrhythmias within a year after the procedure, alongside assessing procedural safety and various secondary outcomes like quality of life and repeat procedures.
- The trial aims to provide insights on whether the new PolarX device can surpass the established Arctic Front technology for pulmonary vein isolation in patients experiencing their first episode of atrial fibrillation.
Background: A novel multipolar pulsed-field ablation (PFA) catheter has recently been introduced for pulmonary vein isolation (PVI). Pre-market data showed high rates for PVI-durability during mandatory remapping studies.
Objective: To present post-market data in patients with recurrent arrhythmias.
Aims: Pulsed field ablation (PFA) is a new, non-thermal ablation modality for pulmonary vein (PV) isolation in patients with atrial fibrillation (AF). The multi-centre EUropean Real World Outcomes with Pulsed Field AblatiOn in Patients with Symptomatic AtRIAl Fibrillation (EU-PORIA) registry sought to determine the safety, efficacy, and learning curve characteristics for the pentaspline, multi-electrode PFA catheter.
Methods And Results: All-comer AF patients from seven high-volume centres were consecutively enrolled.
Background: Pulsed field ablation is a novel nonthermal cardiac ablation modality using ultra-rapid electrical pulses to cause cell death by a mechanism of irreversible electroporation. Unlike the traditional ablation energy sources, pulsed field ablation has demonstrated significant preferentiality to myocardial tissue ablation, and thus avoids certain thermally mediated complications. However, its safety and effectiveness remain unknown in usual clinical care.
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